Provider Type Icon

POUDRE VALLEY MEDICAL GROUP LLC NPI 1215540539


NPI Information

NPI: 1215540539
Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC

Doing Business As: UCHEALTH MEDICAL GROUP

Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 06D2141723

Address:
340 E 1ST AVE STE 101
BROOMFIELD, CO
ZIP 80020
Phone: (303) 544-3800
Get Directions

POUDRE VALLEY MEDICAL GROUP, LLC is an urology in Broomfield, CO. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. POUDRE VALLEY MEDICAL GROUP, LLC NPI is 1215540539. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Uchealth Medical Group.

The provider's business location address is:

340 E 1ST AVE STE 101
BROOMFIELD, CO
ZIP 80020-444
Phone: (303) 544-3800
Fax: (303) 544-3810

The provider's authorized official is Jana Conroy .
The authorized official title is Director Of Credentialing and has the following contact phone number (303) 544-3800.

The CLIA number assigned to this NPI record is 06D2141723 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/26/2020 and was last updated on 3/5/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterologyNo
2207RP1001XInternal MedicinePulmonary DiseaseNo
3207RS0012XInternal MedicineSleep MedicineNo
4208800000XUrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.